Provider Demographics
NPI:1235475385
Name:NEW BEGINNINGS YOUTH FACILITY
Entity Type:Organization
Organization Name:NEW BEGINNINGS YOUTH FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMESHA
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:SPINKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-824-1735
Mailing Address - Street 1:106 WEATHERLY SQ
Mailing Address - Street 2:
Mailing Address - City:RAMSEUR
Mailing Address - State:NC
Mailing Address - Zip Code:27316-8480
Mailing Address - Country:US
Mailing Address - Phone:336-824-1735
Mailing Address - Fax:336-824-1737
Practice Address - Street 1:106 WEATHERLY SQ
Practice Address - Street 2:
Practice Address - City:RAMSEUR
Practice Address - State:NC
Practice Address - Zip Code:27316-8480
Practice Address - Country:US
Practice Address - Phone:336-824-1735
Practice Address - Fax:336-824-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC076-069251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health